UH3CA260607

Survivorship and Access to Care for Latinos to Understand and Address Disparities (SALUD) - Abstract

Pediatric cancer survivors (PCS) experience an excess risk of adverse outcomes related to their cancer diagnosis and the treatment they receive. The accumulation and severity of these acute and chronic health conditions broadly impact PCS functioning, quality of life, and health care resource utilization. Consequently, PCS are more likely to live in financial hardship, have lower educational attainment, be unemployed due to poor health, and be under- or uninsured compared with their age-based peers.

Latino PCS are at particularly high risk for having a lower socioeconomic status (SES) compared with non-Latino PCS. These factors contribute to reduced access to routine medical care and lower overall survival of Latino children diagnosed with cancer.

Existing and well-established patient cohorts of PCS largely include long-term (at least 5 years) survivors and a relatively small proportion of Latino PCS, so that the outcome data that inform our understanding of risk for cancer treatment late effects, and therefore our clinical practice guidelines, are largely derived from the experiences of non-Hispanic white (NHW) PCS.

The overarching objective of this proposal is to identify and comprehensively assess adverse outcomes among Latino PCS that will inform clinical guidelines and lay the foundation for early, targeted interventions to mitigate such outcomes in this vulnerable and growing population of PCS.

Key to the success of our proposal is the prospective establishment of a Latino PCS cohort in Texas that is linked with genomic and geographic data (UG3 planning phase), which will permit analyses of the interaction between ancestry and SES on risk for adverse cancer treatment outcomes during the UH3 implementation phase.

There is a significant unmet need to comprehensively characterize the socioeconomic, psychosocial, genomic, and metabolomic risk determinants of treatment-related toxicities and relapse in Latino PCS in the context of known clinical risk factors. In addition, among under-represented minorities, there is a critical need to identify facilitators and barriers to obtaining survivorship care.

Therefore, utilizing existing and prospectively collected longitudinal data, we will:

(1) Identify demographic, clinical, and genetic/molecular determinants of treatment-related toxicities and their association with chronic health conditions, patient-reported symptoms, and neurocognitive/psychological and functional outcomes in Latino PCS.

(2) Identify demographic, clinical, and genetic/molecular determinants of the excess risk of cancer relapse/recurrence in a cohort of Latino PCS.

(3) Determine Latino PCS understanding of risk for late effects and rationale for survivorship care, and identify perceived facilitators and barriers to obtaining survivorship care.

This proposal synergizes multidisciplinary expertise and data collected from clinical and epidemiological resources to establish a prospective, comprehensive biobank and database inclusive of a large population of Latino PCS. Our aims represent the largest assessment to date of genetic and SES contributors to outcomes in Latino PCS, an effort that is imperative to inform risk assessments for adverse outcomes in an ethno-diverse population, as well as potential barriers to obtaining optimal survivorship care.

Baylor College Of Medicine

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Houston, Texas 770303411 United States

Single Zip Code

Utilizing Cohort Studies to Address Health Outcomes in Cancer Survivors (UG3/UH3 Clinical Trial Not Allowed) (RFA-CA-20-030)

Amendment Since initial award the total obligations have increased 161% from $2,183,284 to $5,696,769.